Retirement Home- Healthy
Mouth
LONG TERM LIVING FACILITY LESSON PLAN
30 MINUTES
Danielle Teachout | Dental Education | February 27 th 2020 | 30 Minute Session
Assessment: The Village is a large nursing home facility located in Indianola,IA. All the residents
currently live full time at The Village. Residents range in ages from 50 and above. The patients at
The Village receive care for long term living, Independent living and memory care. The staff at
The Village are certified nursing assistants and registered nurses. The staff does have some
knowledge of oral hygiene care for their patients. Located in the basement of the building is a
small conference room with a large TV to project a computer screen onto. Training classes are
structured between shift changes. This lesson plan will teach the nursing home staff in
importance of oral health in the elderly community. This plan will cover how to preform a
proper oral exam, what oral lesions to look for in an oral exam, and how to properly care for
their patient’s denture.
Statement of Purpose: According to a study out of Islington, London. “The burden of oral
conditions was considerable among nursing home residents in an inner London borough. The
main clinical issues related to the quality of dentures as well as to the high prevalence of tooth
and root decay. Oral symptoms, such as dry mouth and toothache, were also very common and
they were strongly associated with the residents’ worse” ("The impact of oral health on the
quality of life of nursing home residents" 2015). Teaching the staff about how to properly care
for their elderly patient’s oral health will help maintain a good quality of life for the residents.
Teaching the topics covered here will help our patients have a healthy and pain free oral cavity
while in retirement.
Goals:
1) Understand denture basics
2) Understand denture cleaning
3) Understand common oral lesions that may result from wearing a denture
4) Understand how to conduct dental exams
Goal 1: The nursing staff will understand denture basics
Objective 1: The nursing staff will be able to understand denture basics by following the
presentation to learn how a denture should fit and common questions to ask their patients.;
Cognitive
A: The nursing staff
B: Will be able to understand denture basics
C: Following the presentation
D: How the dentures should fit along with questions to ask the patient regarding their denture
E: 90% of the class will show willingness to add these practices to their daily rounds
Goal 2: The nursing staff will understand denture cleaning
Objective 2: The nursing staff will understand denture cleaning by following the demonstration
on how to properly clean the patient’s denture.; Cognitive
A: The nursing staff
B: Will understand how to properly clean dentures
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C: Following the demonstration
D: How to properly clean dentures
E: 95% of the class will show willingness to add these practices to their daily rounds.
Goal 3: The nursing staff will understand common oral lesions that may result from wearing a
denture
Objective 3: The nursing staff will understand common oral lesions that may result from long
term denture wear by following the presentation of oral lesion pictures; Cognitive
A: The nursing staff
B: Will understand oral conditions that may result from long term denture wear
C: Following the presentation
D: Observing pictures of common oral lesions
E: 80% of the class will be able identify common oral lesions from the handout.
Goal 4: The nursing staff will understand how to conduct dental exams
Objective 4: The students will understand that if there is decay on a tooth a restoration must be
done by the dentist.; Cognitive
A: The nursing staff
B: Will understand how to conduct an oral exam
C: Following the demonstration
D: Where to look in the mouth for common sites of oral lesions (Palate, Submucosa, and sides of
tongue)
E: 90% of the class will show willingness to add these practices to their daily rounds
Introduction/ Lesson Body & Methods:
1) Introduction to the class
a) Have the staff sitting at tables in the lunchroom
b) I will stand in the front of the class to introduce myself and that I am a dental hygiene
student
c) Give a brief overview that we will be talking about today in regard to our patients
wearing dentures
2) Denture Basics!
a) How many of you have treated patients with a full set or partial denture?
b) Dentures should not be uncomfortable or painful for our patients.
c) Dentures should fit snuggly to the patient’s palate.
d) Dentures should ALWAYS be taken out at night
e) Questions to ask our patients about their denture:
How does your denture feel?
How does your mouth feel, any sore spots?
Are you able to eat and drink with your denture?
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3) Cleaning Dentures! - Demonstration
a) Have your patient rinse with water after every meal
b) When your patient is ready for bed make sure the denture has been removed and
placed in a cleaning solution overnight.
c) In the morning remove the denture from the cleaning solution and clean with a soft
denture brush
Always hold the denture close to the bowl. So, if you accidently drop the denture it
wont damage the denture.
d) RINSE THOROUGHLY! – The cleaning solution should not be ingested
e) Dentures should never be left out to dry. This can cause the denture to warp and
change the fit of the denture.
4) Oral Lesions that May Result from Dentures
Denture Stomatitis
Most common oral lesion effecting the palate (50 % of wearers of complete or partial removable
dentures)
Overgrowth of bacteria
Commonly caused by patients that do not remove their denture at night
Angular Cheilitis
Found in the angles or corners of the lips
Appear torn, red and crust formation
Limit the ability to open mouth fully
Can be caused by many different things. Need to be aware of these while preforming an oral
exam.
Traumatic Ulcers
Found on or around the gums of our patients
Caused by ill-fitting dentures
Need to be referred to a dentist to adjust the denture
Patients may experience pain while wearing the denture
Flabby Ridge
Found where the teeth were present
Caused by fibrous tissue growing where the bone was present
Benign condition but something to note in the patient’s chart
Can affect to fit of the denture
Oral Cancer
A sore in the mouth that doesn't heal (the most common symptom).
Pain in the mouth that doesn’t go away (also very common).
A lump or thickening in the cheek.
A white or red patch on the gums, tongue, tonsil, or lining of the mouth.
5) How to Preform an Oral Exam
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a) You will need one piece of gauze, tongue depressor, and good lighting
1. Have the patient remove their dentures
2. Use two fingers and pull up the sides of the cheeks to look at the Maxilla
3. Use two fingers and pull down the sides of the cheeks to look at the Mandible
**Focus on the sides of the cheeks and sides of the gums**
4. Have the patient stick out their tongue. Wrap the tip of the tongue with a piece of
cause. This will allow you to move there tongue easily.
**Focus on the back-lateral sides of the tongue**
5. Have the patient tip their head back to observe their palate
6. Note any abnormalities and refer to physician if needed
Instructional Aids:
Handout is attached
Powerpoint is attached
Closure:
1) Key Points- Review with the students/Thank You
a) Review with the staff dentures should not hurt our patients!
b) Cleaning the denture is important for the health of the patient.
c) Oral lesions can be caused by ill-fitting dentures
d) Oral exams are just as important as physical exams
e) “Thank you for letting me come teach you about your denture care!
2) Questions/Answers (Q= Questions, A= Anticipated Answer, SA= Staff’s Answer)
Q: How often do you provide oral exams?
A: Every 6 months
SA: Oral exams are done upon coming to the facility
Q: What do you currently use for dental treatment referrals?
A: Dentist on staff
SA: There is no longer a dentist on staff so in the event a issue arises we refer the patient to
their outside dentist.
Q: Have you seen any of these lesions in your patients here?
A: Yes
SA: I do not recall currently
3) Handouts
a) Attached is a copy of the handout that will be sent with the employee
Evaluation:
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The overall presentation did not go as expected. We started off about 10 minutes after we
planned. This was because we needed to wait for some of the staff to finish their shift. I started
off with introducing myself to the class. All the staff seemed to be very nice and in well spirits.
Next, I gave my presentation on how to perform oral exams. The staff seemed to know this
material. While teaching the staff about oral lesions some were surprised and maybe disgusted
by the photos. This showed that some of the staff have not seen these lesions in their patients
before. While covering denture cleaning, I felt the staff knew how to clean a denture but not
properly. After the presentation was over, I opened for questions. The staff did not have any
questions for me. I was then dismissed by the director of nursing with directions on how to get
out of the building. Overall, I felt that the nursing staff was set in their ways with oral health
care. I strongly encouraged the importance of this lesson plan but felt as though I was dismissed.
I hope with more dental education from future students or adding a dental hygienist on staff will
promote proper oral hygiene care.
References:
Porter, Jessie, et al. “The Impact of Oral Health on the Quality of Life of Nursing Home
Residents.” Health and Quality of Life Outcomes, BioMed Central, 15 July 2015,
www.ncbi.nlm.nih.gov/pmc/articles/PMC4501060/.
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